Caution: This Can Cause Addiction

evelyne

I opened my low-carb/keto clinic with Nurse Sylvie in February 2017, inside the medical clinic where I do my regular general practice. To get people to enroll, we gave a conference a few weeks before.

I don’t know if you have ever been to Quebec (Canada) in the winter, but there is nothing about a dark freezing weeknight in January to encourage anyone to leave the comfort of their homes, fireplaces and hot chocolates, to come to a free conference. Still, some brave souls did come. And of those, we started up our first two cohorts.

There is so much to learn, as a person, when we start adopting a keto diet. We read, we do self-experiments, and we progress. As doctors, though, there is a lot more to learn, and it can feel overwhelming. It’s enough to make anyone, even the most self-confident amongst us, decide to just not get started yet with patients.

One of the first things I learned as a doctor was what labs to ask for and follow, and why. What is normal, what is expected, and what can be totally and panicky abnormal, while being considered totally OK by other more experienced and cool low-carb practitioners.

Getting patients off medications

The second thing, perhaps, that I had to learn turned out to be my absolute favorite: deprescribing drugs. In North America, and I imagine in most parts of the world, we are trained really well on prescribing medication. Type 2 diabetes is an excellent example: we diagnose it, and then it’s all about adding and combining different drugs, increasing doses, and then starting insulin, and then increasing doses indefinitely.

Those patients never get better. They only get sicker and fatter. They get complications, that we treat with still more drugs, and interventions. But, we do as we’ve been taught, right? We follow the guidelines, right? So we must be helping our patients, right?

The first time I deprescribed a T2DM medication, I felt electrified. My patient had low to normal blood sugar levels on a low-carb diet, after only a few weeks, had lost weight, and was feeling fantastic. Indeed, they were sitting in front of me and smiling.

I thought: “I could get used to this!” What I didn’t know at the time was the addictive nature of having to deprescribe medication because a patient is doing too well.

Two weeks later, more follow-ups. More patients on low-carb doing too well, and needing medication to be stopped. I was really enjoying writing those deprescriptions. I used to look at them and feel proud, and happy. Indeed, I have kept my first original deprescriptions after faxing them, and I was considering framing them, and putting them up on one of my bedroom walls, to get inspired to keep going every morning when I wake up…

Ok. Let’s just say that little project didn’t go too well with hubby, who is totally non-medical, and just doesn’t get the professional satisfaction that comes with those pieces of paper.

But I can tell you who gets it. Colleagues. I think all it takes is one success. One patient who suddenly comes to the office to tell their doctor that they are doing better. The doctor can’t believe they are deprescribing a medication for a disease they were taught was “chronic and progressive”. They feel encouraged to teach it to more patients. They are hooked.

I am a member of a secret FB group of Canadian physicians who have an interest in low-carb diets, for themselves and/or their patients. I have said on a number of occasions to other colleagues in that group: “You don’t need to know everything about low-cab diets and keto diets to start yourself, and to start counseling your patients. You’ll learn and get better as you and your patients progress. It doesn’t have to be perfect, and it doesn’t need to take much of your time. It doesn’t need to be a setup with big cohorts and lots of logistics involved. Just get started. Make the jump. Start with one patient”.

But then I had to add a word of caution: “You might fall in love all over again with your profession, and you might remember why you chose medicine in the first place. Deprescribing is addictive!”

You’ve been warned.


Dr. Èvelyne Bourdua-Roy

More

Low Carb for Beginners

A Ketogenic Diet for Beginners

How to Reverse Type 2 Diabetes

Earlier with Dr. Bourdua-Roy

How I Became an LCHF Doctor Reversing Type 2 Diabetes

“As a Doctor, I Want You to Eat Plenty of Fat, and Add Plenty of Salt to Your Food”

Top videos with low-carb doctors

Top videos about type 2 diabetes

7 comments

  1. Bruce
    This makes me happy, but it makes me even more angry. I had a doctor appointment this morning, and my Doctor is a "red light" for this kind of new information. I live just a couple of provinces over (In Nova Scotia), and us Low Carber's are considered outlaws. My doctor howeve is convinced now that I don't have Diabetes, even though I had an A1C of 7.0 just 4 months ago, and now it is 4.9. He felt he mis-diagnosed it. I purchased "The Obesity Code" for him a month ago, and he wouldn't read it. I reversed my Diabetes in 4 months, and am down 97 pounds. Thank you to all of the doctors who are fighting to change the rules.
  2. Nadine
    I respect all the doctors like you being open minded to the obvious fantastic results and taking the big steps for your patients - you are life changers! I feel it is when the doctors start promoting this lifestyle that the tide will be turned and governments will finally get on board. Thank you!
  3. angie
    I have been doing the LCHF way of healthy eating now for about 47 weeks and after 16 years have come off my insulin pump and have lost 64 pounds besides. I have opened my doctors eyes on my new way of healthy eating and he is surprised by my numbers, as I am. If I can do this anyone can. I want to say Thank You Diet Doctor for opening my eyes. I feel fantastic and have more energy than I have had in years. And I just have to tell you that my husband says for a 57 year old I an HOT. So people don't think you can't do this because you can. Thank You
  4. Anthony Webb
    What an absolutely wonderful article!! I live in the "Diabetic Belt" (Southern U.S.) and have been told I was a Type 2 Diabetic almost 10 years ago. "Traditional treatment" led to the predictable- weight gain, poor BS control, escalation of medications--lather, rinse, repeat. Also, I have been a Nurse for over 30 years, mostly in ER, so I have witnessed the horrors of others' Diabetes escalation firsthand. I have been determined since I was first diagnosed to not be one of the ones who ended up losing limbs, eyesight, renal function, etc., but no matter how I ate, (the way the Diabetes Educator at my Endocrinologist's office 'educated' me to do) I was at best stuck in limbo. Last fall, a friend told me about Dr. Fung's website. Studying his writings led me to click on the link to dietdoctor.com. The combination information from both sources convinced me, and I immediately started Low Carb combined with daily 16:8 and 20:4 I.F. My results have been beyond amazing! I was about 205#, and am now down to 165#. My A1c started at a respectable 6.1, but 3 months ago was already down to 5.1. I was on 2grams Metformin twice daily before starting LC/IF, and the Dr. told me to drop it to half at last visit. I've been doing strict Keto since my last Dr. visit, and my blood sugars have dropped even more, so I cut my Metformin to the point I now take a half a pill only at bedtime (500mg). I have an appointment next month, and am fully expecting my A1c to be below 5. The Dr. told me on my last visit that we might be able to cut the Metformin out completely. I will say she was very supportive when I told her of the lifestyle change I'd adopted. I just wanted to thank Dr.'s Eenfeldt and Fung, for your wonderful websites, and educational material. It has changed my life, actually saved my life.
  5. J. Lance De Foa, MD
    I'm interested in your FB group for Canadian LCHF doctors. I've been telling patients about intermittent fasting for almost two years, started measuring fasting insulin 16 months ago, and talking about LCHF in October. I'm working in white River, Ontario.

    jldefoa

  6. Gail
    That is so awesome! I am not a doctor but after adapting a Keto lifestyle I love to share everything I have learned. It is so rewarding to open their eyes to low carb and try to make a difference in any way possible. Not everybody will make the change but I feel I need to get the word out so friends and family have a choice.
  7. Ariane
    Bonjour Évelyne
    Super de te retrouver sur ce site.
    Comme tu es parfaitement bilingue, pourquoi ne pas en profiter pour proposer tes articles en français ?
    Cela pourrait inspirer des médecins francophones....
    Bonne continuation pour toutes tes activités
    Dr Ariane Monnami

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